First Tears

Man, today was a doozy.  We have amazing friends and neighbors who immediately responded to our request for recommendations with all of their trusted and vetted doctors, dentists, and caregivers for their children.  With this list in hand, I was feeling much more confident about our ability to potentially become parents in just a few days.

Update: we still had not heard back about the beautiful little boy who needed a new home by the weekend, so were still making plans to potentially have a child by the weekend.  Additionally, yesterday we were contacted and asked if we would be interested in submitting for sisters - ages 4 years and 10 mos - which we said yes to, so now we could have two girls if the little boy was not meant to be our son.

So, with a little bit of a potential deadline looming, I began contacting pediatricians and preschools from my trusted list so that we would be as ready as we could be.  I contacted the first pediatrician on the list, where I was promptly informed they do not take Medicaid. -- I should pause here to explain something; as long as we are fostering, our children have to be covered by a type of Medicaid called STAR Health, because they are not technically our dependents and cannot be placed on our private insurance.  Once adopted, they will be covered by traditional Medicaid, but we can make the decision at that time to cover them with secondary insurance under our private insurance if we so wish. --  I continued to make my way down the list, calling pediatrician after pediatrician, being told time and time again that either the doctor did not accept medicaid/star health, or "their allotment for Medicaid was already full and they wouldn't be accepting any new patients".  By the seventh doctor, I was starting to feel frustrated, and asked the receptionist if they had any suggestions or knew of any pediatricians who accepted Medicaid because I was quickly exhausting my list of recommendations.  She responded that she thought urgent care probably does.  URGENT CARE?!?!  A pediatrician is supposed to be a trusted provider to whom you can turn as a parent to ensure that your child is progressing on track, guides you through your child's ups and downs and calms you when you've spent too much time researching 'the worst outcome' online.

I thanked the woman - who was only trying to do her job - and hung up to call the eighth and final recommended pediatrician on my list.  I guess I was a little naive going into this process, and my socioeconomic privilege was shining through wide and clear here; I had never given much thought to how doctors get to decide which insurance they can accept, and how this can be severely limiting for those with already limited insurance options, i.e., those who rely on Medicaid, or even those who cannot afford to choose a PPO like I can.  As I was being told by the receptionist of the last doctor on my list that, no, this doctor doesn't accept Medicaid, my exasperation and frustration boiled to the surface.  With tears forming in my eyes and my voice catching in my throat, I asked her why the practice was not taking Medicaid patients; she said that they only took a certain number and were already maxed out.  I asked, "because the reimbursement rates are lower so you don't make as much?" She kind of stumbled around and couldn't give me a real reason for the limits, and finally admitted that they didn't have similar limits for the various private insurers.  I didn't want someone who was unempowered to change anything to get the brunt of my frustration and anger at the unfairness of the system, so I just thanked her and hung up.

And then I cried.  And cried.  Not because I couldn't find a pediatrician - I knew I would figure that out.  But because the system is broken.  These children who depend on Medicaid need good healthcare, and their parents and caregivers need convenient options so that their parents and caregivers can get to appointments using public transportation, if necessary, and not spend all day sitting in a clinic, especially if they are hourly workers who will be missing pay when they are at their kids' doctors' appointments.  Our neediest and most innocent are the ones who are suffering while private insurance companies are reaping the benefits.  In the second quarter of 2017, while many were decrying how much the Affordable Care Act was costing the insurers, to the point that they were leaving some markets, the top 6 health insurers in the US reported $6 billion in adjusted profit (profit NOT revenue), up 29% from one year prior.  Meanwhile, the average pediatrician in Austin made $189,509 annually (not including bonuses/profit sharing), which in a single-earner household would put them in the top 8% of households in the US.  If you've never given much thought as to why a single payer system would make things more equitable, simplify and reduce complexity in our healthcare system, and reduce rates for all, perhaps this will make you think about it.  I don't want to get too much into politics here, but our kids definitely deserve better.  I dried my tears and resolved that I will use this experience not just to make my children's lives better, but to find a way to make the system better.  

Honestly, I'm too exhausted to even get into the preschool frustrations today, so I'll save that for another day.  Oh, and we also found out that the little boy was placed with a relative, so the wait for our child continues...